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Question
1/5
WHAT BEST DESCRIBES YOUR CURRENT HEALTH STATUS?
I have healthy kidneys and want to learn how to keep them that way
I’ve been told I’m at risk for kidney disease
I have chronic kidney disease (CKD)
I’m living with kidney failure (on dialysis or preparing for transplant)
Question
2/5
HAVE YOU BEEN DIAGNOSED WITH ANY OF THE FOLLOWING?
[Check all that apply]
High blood pressure
Diabetes
Heart Disease
None of the above
Not sure
Question
3/5
WHAT ARE YOU MOST INTERESTED IN LEARNING ABOUT TODAY?
How to keep my kidneys healthy
What to do if I have CKD
What my treatment options are
How to support someone with kidney disease
How to become a kidney donor
Question
4/5
HOW OLD ARE YOU?
Under 18
18-34
35-49
50-64
65 or older
Question
5/5
HAVE YOU HAD A RECENT CHECK-UP OR LAB TESTS RELATED TO YOUR KIDNEYS?
Yes, I’ve had a recent lab test
Not recently, but I’ve had one in the past
No, I’ve never had a kidney-related test
Not sure
Question
Bonus Question
ENTER YOUR EMAIL TO RECEIVE A COPY OF YOUR PERSONALIZED PLAN.
Full Name
Email Address
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